RT Journal Article
T1 Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe.
A1 Judd, A
A1 Lodwick, R
A1 Noguera-Julian, A
A1 Gibb, D M
A1 Butler, K
A1 Costagliola, D
A1 Sabin, C
A1 van Sighem, A
A1 Ledergerber, B
A1 Torti, C
A1 Mocroft, A
A1 Podzamczer, D
A1 Dorrucci, M
A1 De Wit, S
A1 Obel, N
A1 Dabis, F
A1 Cozzi-Lepri, A
A1 García, F
A1 Brockmeyer, N H
A1 Warszawski, J
A1 Gonzalez-Tome, M I
A1 Mussini, C
A1 Touloumi, G
A1 Zangerle, R
A1 Ghosn, J
A1 Castagna, A
A1 Fätkenheuer, G
A1 Stephan, C
A1 Meyer, L
A1 Campbell, M A
A1 Chene, G
A1 Phillips, A
K1 Europe
K1 Perinatal HIV infection
K1 Virological failure
K1 Young people
K1 Adolescente
K1 Adulto
K1 Fármacos anti-VIH
K1 Niño
K1 Enfermedades transmisibles
K1 Intervalos de confianza
K1 Europa
K1 Infecciones por VIH
K1 VIH-1
K1 Recién nacido
K1 Heterosexualidad
K1 Inhibidores de proteasas
K1 ADN polimerasa dirigida por ADN
K1 Inhibidores de la transcriptasa inversa
K1 Factores de riesgo
K1 Carga viral
AB OBJECTIVES:The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection.METHODS:We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged < 20 years at the start of ART for those with perinatal infection and 15-29 years for those with heterosexual infection, with ART containing at least two nucleoside reverse transcriptase inhibitors (NRTIs) and a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (bPI), were followed from ART initiation until the most recent viral load (VL) measurement. Virological failure of a drug was defined as VL > 500 HIV-1 RNA copies/mL despite ≥ 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI.RESULTS:The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4.CONCLUSIONS:The results suggest a beneficial effect of starting ART before adolescence, and starting young people on boosted PIs, to maximize treatment response during this transitional stage of development.
PB Wiley
SN 1464-2662
YR 2017
FD 2017-03-14
LK http://hdl.handle.net/10668/2688
UL http://hdl.handle.net/10668/2688
LA en
NO Judd A, Lodwick R, Noguera-Julian A, Gibb DM, Butler K, Costagliola D et al. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe. HIV Med. 2017;18(3):171-180
DS RISalud
RD Jul 6, 2025